When Is Tinnitus Considered An Emergency?

By Barry Keate
Barry Keate, has lived with tinnitus over 40 years and has published 150+ research articles on numerous aspects of tinnitus. He is an expert on the condition and a well-known advocate for those with tinnitus.

When Is Tinnitus Considered An Emergency


Many conditions cause ringing in your ears. Thankfully, most of them are benign, and you can schedule an appointment with your ear, nose, and throat (ENT) specialist. You don’t have to worry if the appointment is a few weeks out.

Are there cases, though, when tinnitus is a sign of something serious that requires immediate attention? How do you know?

Tinnitus Triage

It can be challenging to know when to see a doctor for tinnitus. Is it an emergency requiring a trip to the ER, or can it wait till your ENT has an opening? When deciding the urgency of seeking treatment, here are some warning signs to watch for:

Facial Paralysis With Tinnitus

If you have a head injury or paralysis in part of your face, call 911 immediately. There are multiple causes, and none of them should be taken lightly.

  • Strokes caused by a blot clot disrupt blood flow to the brain. This condition is the most immediate concern. Some medicines can help, but timing is essential. The sooner they administer treatment, the better the outcome.
  • Bell’s Palsy is an inflammatory response that irritates the nerves controlling the face. Some underlying conditions linked to Bell’s Palsy are Multiple Sclerosis, Lyme Disease, Diabetes, toxin exposure, and Sarcoidosis. It generally lasts two weeks before fading, though it can take several months before patients feel normal again.
  • Ramsay Hunt Syndrome is caused by the chickenpox virus, which can stay in your system long after you recover. In a part of the population, the virus can return in the form of shingles. If shingles rashes break out on the face, they can damage nerves in the face and ear. Rapid treatment may prevent complications like permanent nerve damage.

Pulsatile Tinnitus

Often described as a heartbeat in the ears, pulsatile tinnitus is caused by increased pressure in blood vessels by the ear. While many people can hear their heartbeat after intense exercise or in moments of extreme stress, pulsatile tinnitus is an abnormal and lasting sound without an external source.

The increased pressure in the blood vessels around the ear could stem from plaque in the arteries, high blood pressure, a tumor, increased pressure around the brain, ear abnormalities, blood vessel abnormalities, anemia, Pagget’s Disease (bone malformation), or hyperthyroidism. As several possible causes are time sensitive, don’t try to wait it out. Call your doctor for an appointment.

Sudden Onset Tinnitus And Hearing Loss

Unless preceded by an accident, explosive noise, or other physical cause, tinnitus usually progresses gradually. If it happens immediately without an apparent reason, it’s time to visit your doctor. The National Center for Rehabilitative Auditory Research recommends a same-day appointment with an Audiologist and Otolaryngologist. If you can’t get a same-day appointment, go to the ER.


A persistent ear infection that will not heal may require antibiotics or surgical intervention such as ear tubes. Infection may spread to other areas in the ear or to the bone. In rare cases, it may cause meningitis, where the infection spreads to the protective membrane around the brain or spinal cord.

Unilateral Tinnitus

Tinnitus usually happens in both ears unless you experience trauma to one ear. If you lose hearing or have tinnitus in only one ear, it’s time to see your doctor.

Vestibular Symptoms

If you feel dizziness or vertigo, the most common causes are an ear infection or an inflamed vestibular nerve. That particular nerve sends messages from the ear to the brain, which helps you maintain balance. Unfortunately, vertigo could also be a sign of Meniere’s Disease. The National Institute on Deafness and Other Communication Disorders estimates that 60% of patients with Meniere’s Disease recover fully or can manage symptoms with treatment. In comparison, 40% need surgical intervention to return to regular daily routines.

Suicidal Ideation

Tinnitus is generally benign to the body but can be disruptive and disturbing, especially if it causes sleep deprivation, difficulty working, communicating, or engaging in favorite activities. People with mental illness or prolonged tinnitus stress may feel isolated and depressed. A lack of sleep could also trigger psychosis in those prone to the condition. If you or someone you love is feeling suicidal, go to the ER to be evaluated. There are medical and therapy treatments to help cope with the increased stress caused by tinnitus or other contributing factors.

The Takeaway

Most cases of tinnitus are annoying but harmless. In some cases, it’s even reversible if you treat the underlying condition. You can get tinnitus relief from lifestyle changes, and some show great improvement by taking natural supplements for tinnitus.

However, tinnitus can be a symptom of some other condition rather than a stand-alone disorder. Recognizing dangerous symptoms accompanying tinnitus may save you from unnecessary pain, impairment, or death. When in doubt, it is always better to be evaluated rather than wait and see if the condition goes away on its own.